• Saidul Abrar Health Services Academy,Islamabad.
  • Wajiha Safdar National Radio & Telecommunication Dispensary,Haripur.
  • Muhammad Hanif Quetta Institute of Medical Sciences
  • Nusrat Shujaat Combined Military Hospital Quetta


Background: All definitions of consanguinity encompass the basic concept of close blood relation. Highest rates of consanguineous unions are observed for North and Sub Saharan Africa, Middle East, and west, central and south Asia, where 20–50% marriages are consanguineous. In Pakistan, we can hardly find any rigorous research on the pregnancy outcomes of consanguinity except those conducted by Allan Bittles. This study was conducted with the objective to measure statistically if there existed any association of consanguinity with pregnancy outcomes in the form of stillbirths, abortion and Rh-incompatibility. Methods: This cross sectional analytical study was conducted at the Obstetrics department of Combined Military Hospital Quetta, Pakistan from 1st November 2017 to 28th February 2018. All pregnant women visiting Out Patient Department were included. Women unwilling to participate or needing emergency intervention were excluded. Sample size, i.e., 384 was calculated using online OpenEpi calculator and simple random sampling technique was applied. A structured interviewer administered questionnaire was used to extract retrospective information. Descriptive statistics,95% Confidence Intervals, Chi-Square test and Contingency Coefficient were calculated using SPSS Version 20. Results were regarded significant at p<0.05. Results: Out of 384 study participants, 188 (48.9% with 95% CI:43.9–53.9%) were married to first cousins. Mean±SD age of the study participants was 27.5±4.8 years. Difference between stillbirth, and abortion among consanguineous unions and non-consanguineous unions was significant while that of Rh-incompatibility was non-significant. Conclusion: Large population based studies are needed before declaring consanguinity as a health problem in our setting.Keywords: Consanguinity; Stillbirth; Abortion

Author Biographies

Saidul Abrar, Health Services Academy,Islamabad.

PhD Fellow

Wajiha Safdar, National Radio & Telecommunication Dispensary,Haripur.

Medical Officer

Muhammad Hanif, Quetta Institute of Medical Sciences

Assistant Professor,Community Medicine

Nusrat Shujaat, Combined Military Hospital Quetta

FNS  Major


Definition of consanguinity in English by Oxford Dictionaries [Internet]. Oxford University Press 2018. [cited 16 Mar 2018]. Available from:

Obeidat BR, Khader YS, Amarin ZO, Kassawneh M, Al Omari M. Consanguinity and adverse pregnancy outcomes: the north of Jordan experience. Matern Child Health J 2010;14(2):283–9.

Tamim H, Khogali M, Beydoun H, Melki I, Yunis K. Consanguinity and apnea of prematurity. Am J Epidemiol 2003;158(10):942–6.

al-Salem M, Rawashdeh N. Consanguinity in north Jordan: prevalence and pattern. J Biosoc Sci 1993;25(4):553–6.

Bittles AH. Consanguinity and its relevance to clinical genetics. Clin Genet 2001;60(2):89–98.

Hafez M, El-Tahan H, Awadalla M, El-Khayat H, Abdel-Gafar A, Ghoneim M. Consanguineous matings in the Egyptian population. J Med Genet 1983;20(1):58–60.

Kaiser J. When DNA and culture clash. Science 2016;354(6317):1217–21.

Bittles AH, Black ML. Evolution in health and medicine Sackler colloquium: Consanguinity, human evolution, and complex diseases. Proc Natl Acad Sci 2010;107(suppl 1):1779–86.

Hamamy H, Antonarakis SE, Cavalli-Sforza LL, Temtamy S, Romeo G, Ten Kate LP, et al. Consanguineous marriages, pearls and perils: Geneva international consanguinity workshop report. Genet Med 2011;13(9):841–7.

Modell B, Darr A. Science and society: Genetic counselling and customary consanguineous marriage. Nat Rev Genet 2002;3(3):225–9.

Bittles AH. Consanguinity in Context, Cambridge University Press, New York; 2012.

Do QT, Iyer S, Joshi S. The economics of consanguineous marriages. Rev Econ Stat 2013;95(3):904–18.

Hamamy H, Bittles AH. Genetic clinics in Arab communities: meeting individual, family and community needs. Public Health Genomics 2009;12(1):30–40.

Assaf S, Khawaja M. Consanguinity trends and correlates in the Palestinian Territories. J Biosoc Sci 2009;41(1):107–24.

Romeo G, Bittles AH. Consanguinity in the contemporary world. Hum Hered 2014;77(1-4):6–9.

de Costa CM. Consanguineous marriage and its relevance to obstetric practice. Obstet Gynecol Surv 2002;57(8):530–6.

Yunis K, Mumtaz G, Bitar F, Chamseddine F, Kassar M, Rashkidi J, et al. Consanguineous marriage and congenital heart defects: A case‐control study in the neonatal period. Am J Med Genet A 2006;140(14):1524–30.

Sezik M, Ozkaya O, Sezik HT, Yapar EG, Kaya H. Does marriage between first cousins have any predictive value for maternal and perinatal outcomes in pre‐eclampsia? J Obstet Gynaecol Res 2006;32(5):475–81.

Benson JW. Recessive disorders and consanguineous marriage. BMJ 2005;331(7530):1475.

Hamamy HA, Masri AT, Al-Hadidy AM, Ajlouni KM. Consanguinity and genetic disorders. Profile from Jordan. Saudi Med J 2007;28(7):1015–7.

Al-Gazali L, Ali BR. Mutations of a country: a mutation review of single gene disorders in the United Arab Emirates (UAE). Hum Mutat 2010;31(5):505–20.

Teebi AS, editor. Genetic disorders among Arab populations. 2nd ed. Berlin; New York, NY: Springer-Verlag, 2010; p.772.

Bittles AH, Black ML. The impact of consanguinity on neonatal and infant health. Early Hum Dev 2010;86(11):737–41.

Bittles AH. A community genetics perspective on consanguineous marriage. Community Genet 2008;11(6):324–30.

Grjibovski AM, Magnus P, Stoltenberg C. Decrease in consanguinity among parents of children born in Norway to women of Pakistani origin: a registry-based study. Scand J Public Health 2009;37(3):232–8.

Yunis K, El Rafei R, Mumtaz G. International Perspectives: Consanguinity: Perinatal Outcomes and Prevention–A View from the Middle East. NeoReviews 2008;9(2):59–64.

Bittles AH, Grant JC, Shami SA. Consanguinity as a determinant of reproductive behaviour and mortality in Pakistan. Int J Epidemiol 1993;22(3):463–7.

Al-Quran, Chapter 4:Al-Nisa,Verse 23.

Dean A, Sullivan K, Soe M. Open Source Epidemiologic Statistics for Public Health [Internet]. OpenEpi. 2013 [cited 29 Oct 2017]. Available from:

Regan L, Rai R. Epidemiology and the medical causes of miscarriage. Baillieres Best Pract Res Clin Obstet Gynaecol 2000;14(5):839–54.

WHO. Maternal, newborn, child and adolescent health. [Internet]. World Health Organization. 2018 [cited 18 Mar 2018]. Available from:

Islam MM. The practice of consanguineous marriage in Oman:prevalence, tends and determinants. J Biosoc Sci 2012;44(5):571–94.

Wong SS, Anokute CC. The effect of consanguinity on pregnancy outcome in Saudi Arabia. J R Soc Health 1990;110(4):146–7.

Riaz HF, Mannan S, Malik S. Consanguinity and its socio-biological parameters in Rahim Yar Khan District, Southern Punjab, Pakistan. J Health Popul Nutr 2016;35(1):14.

Ahmad B, Rehman AU, Malik S. Consanguinity and inbreeding coefficient in tribal Pashtuns inhabiting the turbulent and war-affected territory of Bajaur Agency, North-West Pakistan. J Biosoc Sci 2016;48(1):113–28.

Khoury SA, Massad DF. Consanguinity, fertility, reproductive wastage, infant mortality and congenital malformations in Jordan. Saudi Med J 2000;21(2):150–4.

Hussain R, Bittles AH, Sullivan S. Consanguinity and early mortality in the Muslim populations of India and Pakistan. Am J Hum Biol 2001;13(6):777–87.

Saad FA, Jauniaux E. Recurrent early pregnancy loss and consanguinity. Reprod Biomed Online 2002;5(2):167–70.

al-Eissa YA, Ba'Aqeel HS. Risk factors for spontaneous preterm birth in a Saudi population. Eur J Obstet Gynecol 1994;57(1):19–24.

Pedersen J. The influence of consanguineous marriage on infant and child mortality among Palestinians in the West Bank and Gaza, Jordan, Lebanon and Syria. Community Genet 2002;5(3):178–81.

Jaber L, Romano O, Halpern GJ, Livne I, Green M, Shohat T. Awareness about problems associated with consanguineous marriages: survey among Israeli Arab adolescents. J Adolesc Health 2005;36(6):530.

Kapurubandara S, Melov S, Shalou E, Alahakoon I. Consanguinity and associated perinatal outcomes, including stillbirth. Aust N Z J Obstet Gynaecol 2016;56(6):599–604.

Kulkarni ML, Kurian M. Consanguinity and its effect on fetal growth and development: a south Indian study. J Med Genet 1990;27(6):348–52.

Qandalji BM. Consanguinity and pregnancy outcome. Arch Dis Child 2008;93(Suppl 2:ps100.

Nath A, Patil C, Naik VA. Prevalence of consanguineous marriages in a rural community and its effect on pregnancy outcome. Indian J Community Med 2004;29(1):3.

Gowri V, Udayakumar AM, Bsiso W, Al- Farsi Y, Rao K. Recurrent early pregnancy loss and consanguinity in Omani couples. Acta Obstet Gynecol Scand 2011;90(10):1167–9.

Cole SW. Human social genomics. PLoS Genet 2014;10(8):e1004601.

Al Arrayed S. Campaign to control genetic blood diseases in Bahrain. Community Genet 2005;8(1):52–5.

Overall ADJ. The influence of the Wahlund effect on the consanguinity hypothesis: consequences for recessive disease incidence in a socially structured Pakistani population. Hum Hered 2009;67(2):140–4.




Most read articles by the same author(s)